How to Treat Asthma, Chronic Bronchitis & Emphysema

How to Treat Asthma, Chronic Bronchitis & Emphysema

These three breathing disorders (asthma, chronic bronchitis, emphysema) are very common. Almost 20 million people in the United States have asthma. Emphysema and chronic bronchitis are the second most-common medical conditions responsible for people stopping work and the fourth leading cause of death in the United States.

How to Treat Asthma, Emphysema and Chronic Bronchitis (COPD)

In asthma, the breathing tubes called bronchi temporarily narrow or collapse (bronchoconstriction). This reduces the flow of air into the lungs. Common asthma symptoms are wheezing, coughing, shortness of breath, and inflammation of the airways.

Unlike the temporary interference with airflow caused by asthma, in emphysema and chronic bronchitis airflow is persistently blocked. These latter breathing disorders are very descriptively and commonly called chronic obstructive pulmonary disease (COPD).

The most common symptoms include cough, with phlegm, and shortness of breath. By far, the most important cause of COPD is cigarette smoking, although it can also be caused by exposure to chemical fumes, dust, and other air pollutants.

Asthma:

Two types of medicines are used to treat asthma – those that stop asthma symptoms and those that prevent asthma symptoms from occurring in the first place. The choice depends on how severe the symptoms are and the frequency with which they occur.

Drugs that stop asthma symptoms by rapidly opening up airways are called bronchodilators. In asthma, inflammation swells the airways, which interferes with airflow. Anti-inflammatory drugs reduce this inflammation and are used to prevent attacks from occurring in the first place, or at least reduce the frequency with which they occur.

Did You Know That … ?

Steroids ore the most commonly used anti-inflammatory drugs. In addition to being used for asthma, steroids ore used for the treatment of dozens of different medical conditions, including severe allergies, skin and eye disorders, rheumatoid arthritis, hormone deficiencies, certain cancers, multiple sclerosis, and disorders of the blood and gastrointestinal tract.

Airway-Opening Drugs:

To stop an attack after it has started, albuterol and similar quick-relief drugs are the fastest acting and most effective medicines available. They act by opening air passages that are narrowed as the result of asthma. Long-acting airway openers such as salmeterol and formoterol are used to prevent attacks.

Quick-relief airway openers are inhaled from a handheld metered-dose inhaler (MDI) or nebulizer. After being inhaled, welcome breathing relief starts within minutes and continues for three to six hours.

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A metered-dose inhaler (MDI) is a small, handheld pressurized device. Each time the MDI is activated, it delivers a fine spray, which contains a premeasured dose of drug. A nebulizer has a rubber bulb that, when squeezed, delivers a mist of drug. Nebulizers are easier to learn to use than MDls.

What can be done when asthma attacks occur frequently? Long-acting airway openers, such as salmeterol, are used to prevent attacks. After being inhaled, this drug opens airways for up to 12 hours. Because there is a considerable delay before it begins to work about 20 minutes – this drug is of little value when frantically gasping for air.

Use cautiously if you have diabetes, overactive thyroid, heart disease, high blood pressure, or angina (chest pains). Side effects are usually are minimal and include a rapid heartbeat, heart palpitations, and tremors.

Warning!

Airway-opening drugs should restore normal breathing within 20 minutes. If they don’t, seek medical assistance immediately! Avoid the natural temptation to take higher doses or take doses more often than have been prescribed. Long-acting airway openers should never be used to replace the quick-acting inhalers!

Anti-Inflammatory Drugs:

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Steroids are the most important anti-inflammatory drugs used to prevent asthma symptoms and stop severe attacks.

Patients experiencing symptoms on a frequent basis commonly use inhaled steroids, such as beclomethasone, to prevent attacks. Inhaled steroids do not provide help in stopping an asthmatic attack when it is in progress because they cannot open narrowed airways.

Inhaled steroids are sometimes used in combination with airway opening drugs. Inhaled steroids must be used every day, for up to four to six weeks, before early signs of improvement are seen. Such favorable signs include fewer episodes of breathing difficulties or less severe symptoms when they do occur.

These drugs must be taken for several additional weeks before their maximum benefits kick in. To treat severe cases of asthma that cannot be adequately controlled with safer drugs, steroids are taken by mouth. The beneficial effects produced by such oral steroids as prednisone are often nothing short of dramatic and may be even lifesaving.

As good as they are, when oral steroids are used for long periods, at high doses, they may cause severe side effects. When the time comes to stop taking steroids, it must be done gradually. When properly used, steroids can be lifesaving drugs. When improperly used, their adverse effects can affect organs throughout the body.

In general, steroids should be taken at the lowest effective doses for the shortest period of time.

Some major problems include …

  • Adrenal insufficiency. High steroid doses cause the adrenal glands to shut down and become unable to release natural steroids when the body is confronted with stress.
  • Bone-loss, osteoporosis, and bone fractures.
  • Increased susceptibility to infections.
  • Loss of control of sugar levels in diabetics.
  • Muscle weakness.
  • Salt and water retention, causing high blood pressure.
  • Suppression of growth in children.
  • Behavioral and mood changes, such as depression or a high feeling (euphoria).
  • Cataracts and glaucoma.
  • Peptic ulcer disease.

Steroids should not be used by people with systemic fungal infections or those receiving live-virus vaccines.

Steroids should be used cautiously in children and pregnant or nursing women – also by people with high blood pressure, heart failure, kidney disease, peptic ulcers, diabetes, osteoporosis, and infections resistant to treatment.

Inhaled steroids are quite safe. Side effects include cough, dry mouth and throat, hoarseness, and thrush (a fungal infection of the mouth). To prevent thrush, patients should rinse their mouth with water after each use of a steroid inhaler.

Maximizing Your Medicine

Medicines used for the treatment of asthma and COPD are commonly inhaled using either a metered – dose inhaler or a nebulizer. When used properly – which is the only way these devices will be of benefit-they rapidly deliver medication to the intended location in the airway tubes while minimizing their effects on other parts of the body.

Inhalers don’t help much if they are not used correctly,and so users must be taught the skills needed to use them correctly. Work carefully with your health-care provider to learn and master the use of the inhaler before you need it most.

Emphysema & Chronic Bronchitis (COPD):COPD

Many of the same drugs used to treat asthma are also useful in relieving the shortness of breath seen in COPD. Unfortunately, none of the available medicines reverse existing lung damage and obstructed airflow.

Airway-Opening Drugs:

Similar drugs are used to treat COPD as asthma and are inhaled using a metered dose inhalator or nebulizer. Albuterol and other quick-relief drugs are used to relieve sudden shortness of breath in COPD and long-acting airway openers, such as salmeterol, are inhaled to prevent breathing difficulties.

Inhaled ipratropium taken alone or in combination with albuterol is often the first drug choice used to prevent COPD attacks.

Ipratropium is an atropine-like drug that may cause dry mouth and a headache. This drug should be used cautiously by individuals suffering from glaucoma or prostate enlargement.

Maximizing Your Medicine

Drugs used for the treatment of chronic obstructive pulmonary disease (COPD) can prevent the disorder from worsening and can improve breathing. Whereas these drugs are useful, the most important treatment is to stop smoking.

As COPD progresses, shortness of breath becomes more extreme and is worsened by exposure to polluted air. Pneumonia or bronchitis cause flare-ups and are treated with antibiotics and may require that the patient be hospitalized.

In advanced cases of COPD, oxygen therapy is often required. Homebound individuals can use electrically driven devices that concentrate oxygen from the air. Liquid (compressed) oxygen, contained in small portable tanks, can be used by individuals up and about and away from the house for periods of several hours at a time.

Anti-Inflammatory Drugs:

When other drugs are not effective, inhaled steroids are used to reduce symptoms and prevent flare-ups. Unfortunately, they do not prevent loss of lung function. Oral steroids are used to stop flare-ups that are not controlled with safer drugs.

How to Treat Asthma, Chronic Bronchitis & Emphysema with Drugs & Medication:

  • Some medicines are used to treat the symptoms of asthma, whereas others prevent these symptoms from occurring. Sometimes better results are obtained when these drugs are used in combination. How the physician decides which approach is more appropriate depends on the symptoms.
  • If asthma symptoms occur infrequently, there is no need to take medication each and every day.
  • For fast relief of asthma symptoms, take a short-acting inhaled drug that opens airways.
  • To prevent or control regularly occurring asthma symptoms, use inhaled steroids every day.
  • To control asthma symptoms that occur every day, use both an inhaled steroid and a long-acting inhaled drug that opens airways.
  • Drugs used for the treatment of emphysema and chronic bronchitis prevent the disease from worsening and can improve symptoms.
  • The best treatment for COPD is to avoid smoking.
  • In addition to drugs used for asthma, inhaled ipratropium is used to prevent COPD attacks .
  • In advanced cases of COPD, oxygen therapy may be required.

Drugs for Asthma, Emphysema, and Chronic Bronchitis:

Generic Name Trade Name Generic Available
Open Airways
Albuterol Proventil, Ventolin Yes
Formoterol Foradil No
Fluticasone/ Salmeterol Advair Diskus No
Ipratropium Atrovent Yes
Levalbuterol Xopenex No
Salmeterol Serevent Yes
Terbutaline Brethine, Bricanyl Yes
Theophylline Theo-Dur, Theovent, Uniphyl Yes
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Anti-Inflammatory
Beclomethasone Beclovent Yes
[Beclometasone] Vanceril
Budesonide Pulmicort Yes
Fluticasone Flovent No
Fluticasone/ Salmeterol Advair Diskus No
Methylprednisolone Medrol Yes
Montelukast Singulair No
Prednisone Deltasone, Meticorten Yes
Zafirlukast Accolate No
Zileuton Ziflo No

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